原文翻译

                                                Shrinks, expanded  收缩，膨胀

                    There are not enough psychiatrists. Trained laypeople can often help

                                                                     没有足够多的精神病专家，可以训练外行人来帮忙

    In any given year one person in six is afflicted by a mental illness. Most cases involve mild-to-moderate depression or anxiety. Some sufferers recover on their own. For many, however, the condition is left untreated and may become chronic or severe. In the past social stigma meant that people kept their pain to themselves. The stigma is now melting away. Yet in rich Western countries two-thirds of people with a mental-health problem do not receive any treatment for it. In poor countries hardly any do. And almost everywhere, psychiatrists and clinical psychologists are scarce. Often they are the only people whom states or insurers will pay to treat mental illness, so those who seek help must wait months for it. The cost in human misery is huge. Mental-health care needs to change.

    在任何一年，每六个人中就有一个人被精神疾病所折磨。大多数的案例都涉及轻度到中度压抑和焦虑。有些患者可以自行康复，但是对大多数人而言，病情没有得到治愈且可能变成慢性或者更加严重。在过去社会耻辱意味着人们自食其痛楚，现在这种耻辱正在消失。然而在富有西方国家中，仍有三分之二的人患有精神健康问题没能去接受任何治疗，更别提在贫穷的国家。并且在绝大多数地方，精神病学家和临床心理学家很少，通常，他们是州或保险公司为治疗精神疾病而支付的唯一人，因此寻求帮助的人必须等待数月。在人类痛苦上的花费是巨大的。精神很健康医疗需要改变。

    In particular, the psychiatric profession’s over-tight grip should be challenged. Talk therapy, which the World Health Organisation recommends as a first line of treatment for mild-to- moderate depression and anxiety, can be delegated to non-specialists—a concept known as “task-shifting” (see International section).

    特别是，精神病专业的过度紧握应该受到挑战。 世界卫生组织建议将谈话疗法作为轻度至中度抑郁和焦虑的第一线治疗方案，可以委托给非专科医生 - 一种被称为“任务转移”的概念（见国际部分）。

    The experiences of two very different places—England and Zimbabwe—demonstrate that this approach can work on a national scale anywhere. England blazed a trail by training a new cadre of talk-therapy practitioners using a one-year boot camp. Graduates of the scheme typically provide cognitive-behavioural therapy (cbt).

    两个截然不同的地方 - 英格兰和津巴布韦 - 的经验表明，这种方法可以在全国范围内发挥作用。 英格兰开辟了一条道路，通过一年训练营训练一批新的谈话治疗从业者。 该计划的毕业生通常提供认知行为疗法（cbt）。

    This involves teaching people to spot the real-world situations that set off their negative thoughts, fears and anxieties, such as awkward social gatherings or meeting the boss. It then offers concrete steps for dealing with them, such as going on a walk with a friend or reminding yourself that you got a bonus so the boss probably doesn’t think you are useless. Half of those who complete two or more therapy sessions for depression or anxiety recover (though some would have anyway). Zimbabwe has been training elderly women to provide something like cbt on “friendship benches” set up in courtyards.

    这涉及教导人们发现现实世界的情况，引发他们的负面想法，恐惧和焦虑，例如尴尬的社交聚会或与老板见面。 然后它提供了处理它们的具体步骤，例如与朋友散步或提醒自己你有奖金，所以老板不会认为你没用。 完成两次或更多次抑郁或焦虑治疗的人中有一半恢复（尽管有些人会有所反应）。 津巴布韦一直在培训老年妇女，为在庭院中设立的“友谊长椅”提供类似认知行为疗法的服务。

    Both programmes are inspiring imitators. Scotland, whose health service is run independently from England’s, has a similar scheme. Canada, Norway and New Zealand are also using ideas from England. Zimbabwe’s approach has been imitated not only in other African countries but even in New York.

    这两个项目都是鼓舞人心的模仿者。 苏格兰的卫生服务独立于英格兰，有类似的计划。 加拿大，挪威和新西兰也在使用来自英格兰的想法。 津巴布韦的做法不仅在其他非洲国家，甚至在纽约都被模仿。

    The benefits can be enormous. Even mild forms of distress affect work, child-rearing and physical health. Social anxiety may keep someone at home. A depressed mother may struggle to care for and play with her child in the early months so crucial for brain development. In Britain about 11% of workers’ sick days are because of mental-health problems. Those who struggle into work despite such problems are, on average, less productive. Add in disability payments to those who drop out completely, and the annual cost in Europe is nearly 3% of gdp, by one estimate.

    这好处可能是巨大的。 即使是轻微的痛苦形式也会影响工作，抚养孩子和身体健康。 社交焦虑可能使人留在家中。 抑郁的母亲可能很难在早期对孩子进行照顾和玩耍，这对大脑发育至关重要。 在英国，大约11％的工人生病日是因为心理健康问题。 那些尽管遇到这些问题而努力工作的人平均来说生产力较低。 根据一项估计，向完全退学的人增加残疾补助金，欧洲的年度费用几乎是国内生产总值的3％。

    Yet too little use is made of cheap talk-therapy. Critics complain that standardised sessions can never fit the unique circumstances of each person’s distress. But the alternative is usually no care at all, or advice from charity helplines. Psychiatrists, as eager as any other guild to protect their turf, often warn that therapists who have not studied psychiatry may provide poor-quality care. In fact, plenty of evidence shows that, with proper supervision, trained amateurs do a good job. The old notion that doctors must do everything is not only impractical; it is also disproved by experience. In many places, nurses do tasks once reserved for doctors, including anaesthesia, endoscopy and emergency care. Community health workers in poor countries (sometimes known as “barefoot doctors”) treat malaria and diagnose pneumonia.

    然而，廉价的谈话疗法使用得太少了。 批评者抱怨说，标准化课程永远不能适应每个人痛苦的独特情况。 但是替代方案通常根本没有关心，或者来自慈善机构帮助热线的建议。 精神病学家和任何其他行会一样渴望保护他们的地盘，他们经常警告说，没有学过精神病学的治疗师可能会提供质量低劣的护理。 事实上，大量证据表明，经过适当的监督，训练有素的业余爱好者可以做得很好。 医生必须做的每件事的旧观念不仅不切实际; 它也被经验所反驳。 在许多地方，护士会为医生做一些任务，包括麻醉，内窥镜检查和急诊护理。 贫穷国家的社区卫生工作者（有时称为“赤脚医生”）治疗疟疾和诊断肺炎。

   The same kind of approach can work for mental health. Indeed, with so many more sufferers than can plausibly see a specialist, cheap talk with trained laypeople is the only practical way to bring relief—and turn millions of lives around.

   同样的方法可以用于心理健康。 事实上，如果有更多的受害者可以看到专家，那么与训练有素的外行人进行廉价谈话是带来救济的唯一实用方法 - 并且可以改变数百万人的生命。

单词记忆

1. shrink 收缩

2.psychiatrist  精神病医生

3. laypeople  门外汉

4. be  afflicted by  被……所折磨

5. mild-to-moderate  轻度至中度

6. chronic  慢性的

7. social stigma  社会耻辱，社会污点

8.  melt away 消失

9. clinical psychologists 临床心理学家

10.  be scarce  缺乏的，罕见的

11. human misery 人类痛苦

12. be  delegated to  被授权/委托给……

13. blaze  公开宣布

14. a cadre of…… 一组……成员

15. boot camp 训练营地

16. talk-therapy  谈话疗法

17. cognitive 认知的，有认识力的

18. spot the real-world situation 指出现实世界状况

19. set off negative thought 引发消极思想

20. inspire    鼓舞人心的

21. Scotland 苏格兰  Canada 加拿大 Norway 挪威  New Zealand 新西兰

22. enormous  adj.庞大的，巨大的；凶暴的，极恶的

23. child-rearing   孩子抚养

24.  standardised sessions    标准化课程

25. guild  协会

26. protect their turf  保护他们的地盘

27. supervision  监管

28. the old notion 旧的观念

29. disproved   证明理论错误，反驳

30.   impractical  不切实际的

31.  task任务

32. anaesthesia  麻醉

33.  endoscopy   内窥镜检查

34.  emergency care  紧急护理

35. malaria  疟疾

36.  diagnose pneumonia  诊断肺炎

37. sufferer n. 受害者；受难者 患病者

作文句子

1. In any given year one person in six is afflicted by a mental illness

  在任何一年，每六个人中就有一个人被精神疾病所折磨。

for example:可以用于环境类，健康类描述，多少人中有多少人被啥啥所影响，困扰等

2. the condition is left untreated and may become chronic or severe

 情况没有得到治愈且可能变成慢性或者更加严重

for example:可以用于环境类，健康类描述，某某类问题不解决就会变得更加……

3. this approach can work on a national scale anywhere

   在全国范围内发挥作用

for example:用来追加形容自己提出解决某类问题的措施

4. spot the real-world situations that set off their negative thoughts, fears and anxieties

 发现现实世界的情况，引发他们的负面想法，恐惧和焦虑

for example:用于描述现状或者在措施中说要引起公众的注意力

5.offers concrete steps for dealing with them

  提供了处理它们的具体步骤

for example:用于描述措施

6. The old notion that doctors must do everything is not only impractical; it is also disproved by experience.

  医生必须做的每件事的旧观念不仅不切实际; 它也被经验所反驳。

for example:在描述措施的时候，可以先提出啥啥旧观点是错误的，比如解决啥问题不能只靠谁谁谁